A retrospective study of sequential laser treatments for early stage of facial post-traumatic scars which were managed by plastic surgeons: outcome and time of intervention
10.3760/cma.cn114453-20200612-00358
- VernacularTitle:激光序列治疗面部美容缝合术后早期瘢痕临床效果的回顾性研究
- Author:
Qing YANG
1
;
Wenjie DOU
;
Yue YIN
;
Xianjie MA
;
Ping XUE
;
Tong LI
;
Xing FAN
;
Baoqiang SONG
Author Information
1. 空军军医大学第一附属医院整形外科，西安 710032
- Keywords:
Scar;
Pulsed dye laser;
CO 2 ablative fractional laser
- From:
Chinese Journal of Plastic Surgery
2020;36(10):1075-1079
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the efficacy and intervention time of sequential laser treatments for early stage of facial post-traumatic scars which were managed by plastic surgeons.Methods:212 patients in our department with facial post-traumatic scar which were managed by plastic surgeons within 2-12 weeks received 3-session of sequential 595 nm and CO 2 ablative fractional lasertreatments at 8 weeks intervals. They were divided into four groups in this retrospective study. Traumatic scars were first treated by 595 nm pulsed dye laser at 2 weeks (group A), 4 weeks (group B), 8 weeks (group C), 12 weeks (group D) post-operation respectively. Until the vascularity scores of Vancouver scar scale (VSS) fell below 2 points, then scars were treated with CO 2 ablative fractional laser. During the study, all cases were treated with standard silicone gel. Photographs taken before and after each treatment session were independently evaluated and scored by two uninvolved doctors with Vancouver scar rating scale (VSS). Friedman test and Mann-Whitney U test were used for intragroup and intergroup comparison of the difference before and after each session treatment. Patients, self-satisfactory (on 0-100%) and adverse effects were recorded and Chi-square and Fisher’s exact test were used to compare the differences between groups. Results:All 4 groups of patients completed 3-session laser treatments. The VSS score of A/B/C/D group was 3.0 (3.00-5.00) /4.0(3.00-4.00) /6.0 (5.00-6.00) /6.5 (6.00-7.75) at baseline, and significantly decreased to 2(2.00-3.00)/2(2.00-3.00)/4(3.00-4.00)/4(4.00-4.75) at 2 months after 3-session treatment ( P<0.001) respectively. Compared VSS score intergroup, there was no statistically difference between group A and B before ( P>0.05) or after ( P>0.05) treatment. In contrast, compared with group C or D, VSS score of group A or B was significantly lower at baseline ( P<0.001) and final follow-up ( P<0.001). And the excellent rate of patients, self-satisfaction were significantly different for group A(80.77%) vs. group C(56.41%) or D(47.50%), and group B(75.61%) vs. group C or D( P<0.05). No significant adverse effects were reported except for 3 patients with mild transient vesicles, and amonge the 3 cases, hyperpigmentation was observed in 2 cases which was faded within 6 months. Conclusions:A combination of 595 nm pulsed dye laser and CO 2 ablative fractional laser for facial traumatic scars starting from 2 weeks to 1 month post-operation could reach better clinical outcome by attenuating scar formation effectively and with higher patients, self-satisfaction than that from 2-3 months post-operation.
